The operative approach to midclavicular fractures have traditionally been plate osteosynthesis or intramedullary nailing. Poigenfürst in 1992 showed in a series of 122 patients a low nonunion rate and good functional results after plating. Likewise, intramedullary nailing has been described as an alternative technique with good results. Kettler demonstrated en a series of 87 patients a good functional results union in 97,7 % ( 85 of 87) and no infections. Similar results were fond by Rehm in 2004, with one nonunion of 136 fractures treated and a constant score one year after implant removal of 97.